'When you hear hoofbeats, think of horses not zebras' - the old adage is well-known to GPs but what should you do when faced with a zebra, not a horse? Consultant cardiologist Professor Robert Tulloh and GP Dr Louise Tulloh kick off our new series with their advice on how to catch Kawasaki disease in general practice.

Dr Eugene Hughes, a GP on the Isle of Wight and a member of Primary Care Diabetes Europe, said GPs would concentrate on conditions in the quality framework that make them more money.

He said: 'GPs will mobilise themselves to meet the standards in the quality framework, perhaps to the detriment of other conditions. When you work in an under-funded service you become quite good at going after pots of money up for grabs.'

Dr John Haughney, a GP in East Kilbride and chair of the General Practice Airways Group, said patients with conditions such as rheumatoid arthritis or migraine could miss out unless safeguards were put in place. He said: 'I am confident my fellow GPs are not driven by money alone and do want the very best for patients. But if certain conditions are incentivised, I would want to make sure others don't fall by the wayside.'

Dr Henry Smithson, a GP in Escrick, North Yorkshire, who has an interest in epilepsy, said the contract may push GPs to specialise in conditions in the quality framework. He said: 'I would hope we continue to provide a high-quality service rather than being mini-specialists in conditions earmarked by the Government.'

Dr Tony Snell, co-deputy chair of the NHS Confederation core negotiating team, dismissed the idea the contract would create a two-tier service as a 'false premise'.

He said: 'Why should GPs provide inferior standards of care because other disease areas are given higher public expression in the new contract? There is nothing in the new contract saying stop offering a high-quality service.'

But Professor Ian Watt, professor of primary and community care at the University of York and an expert in evidence-based medicine, said there was evidence to prove the concerns were 'well founded'.

Professor Watt, a GP in Catterick, North Yorkshire, said: 'You have to be careful